Journal of Ultrasound in Medicine, Vol 7, Issue 7 381-387, Copyright © 1988 by American Institute of Ultrasound in Medicine
Vaginal sonography in ectopic pregnancy. A prospective evaluation
A. Rempen
Department of Obstetrics and Gynecology, University of Wurzburg, West Germany.
Among 404 first-trimester pregnancies examined with vaginal sonography in a
prospective study, there were 21 ectopic gestations. Considering only the
initial scans, the endometrial canal showed a linear echo surrounded by an
echogenic zone in 18 cases, but in three cases the uterine cavity
demonstrated a small echo-free area representing blood. Free fluid within
the cul-de-sac was seen in 17 patients. An adnexal tumor representing the
extrauterine gestation, was detected in 19 cases. Fifteen of these masses
exhibited a thick-walled ring characteristic of a gestational sac with a
viable embryo in five cases and a yolk sac in one. Other cystic adnexal
masses, such as corpus luteum cysts, seen in 14 of the 21 patients were not
confused with the ectopic pregnancy. A correct tentative diagnosis of
ectopic gestation was made in 18 patients (86%) after the initial scan and
in 20 cases (95%) including four controls. There was one false-positive
suspicion of ectopic gestation in a patient who actually had a spontaneous
abortion. Interpretation of the sonographic image should generally be done
in correlation with laboratory and clinical data. The results of the study
indicate that vaginal sonography is a valuable diagnostic procedure in the
evaluation for ectopic pregnancy.
